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Simple Excision (simple + excision)

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Medical Sciences	100%

Selected Abstracts

Vascular Leiomyoma of the Head and Neck

THE LARYNGOSCOPE, Issue 4 2004
Cheng-Ping Wang MD
Abstract Objectives/Hypothesis Vascular leiomyoma, a benign tumor composed of smooth muscle cell and vascular endothelium, is rare in the head and neck region. The authors report their experience with 21 patients. Study Design Retrospective review. Methods From 1988 to 2001, the clinical records of 21 patients with vascular leiomyoma of the head and neck were reviewed. The pathological material of each tumor was reviewed again for confirmation of the diagnosis and histological classification proposed by Morimoto. Results Twelve male and 9 female patients were studied. The mean age was 48 years. The locations and numbers of cases of the tumors were as follows: auricle, five; nasal cavity, three; external nose, 3; neck, 3; lip, 3; inner canthus, 2; forehead, 1; and hard palate, 1. All tumors were painless, and most were less than 2 cm in diameter. Three vascular leiomyomas of the neck were larger than 2 cm. Two of the three tumors originating in the nasal cavity presented with nasal obstruction or epistaxis. Regarding histological subtype, 14 of 21 (67%) tumors were solid type; 6 (28%) were cavernous type, and only one (5%) was venous type. Only one tumor (5%) recurred after excision. Conclusion Vascular leiomyoma usually presents as a small, painless mass. Auricle, nose, lip, and neck are the most common sites of occurrence. Unusually large vascular leiomyomas are developed in the deep space of the neck. Imaging study or cytological examination is not helpful for diagnosis. Histological classification is not necessary. Simple excision yields excellent results. [source]

Effect of Perilesional Injections of PEG-Interleukin-2 on Basal Cell Carcinoma

DERMATOLOGIC SURGERY, Issue 11 2000
Baruch Kaplan MD
Background: Multiple modalities are available for the treatment of basal cell carcinoma (BCC). The most commonly used modalities include simple excision, Mohs micrographic surgery, curettage and electrodessication, cryosurgery, and irradiation therapy. Interleukin-2 (IL-2) is a cytokine produced chiefly by activated T lymphocytes and has effects on various components of the immune system. Until now the primary clinical use of IL-2 has been in advanced stages of metastatic melanoma and renal cell carcinoma. Systemic administration of IL-2 is known to cause significant toxicity. Objective: The objective of this study was to evaluate the therapeutic efficacy and safety of perilesional PEG-IL-2 injections in patients with BCC in an open label, uncontrolled pilot study. Methods: Patients with histologically confirmed primary BCC over 18 years of age were included in the study. Lesions were treated by injecting a total volume of 0.5 cc of IL-2 in a radial fashion in the subcutaneous tissue. Injection dosages ranged from 3000 to 1,200,000 IU in one to four weekly dosages. A total of 12 tumors were treated in eight patients. Results: Overall response rates were as follows: complete response in 8 of 12 treated tumors (66.6% cure rate), partial response in 3 of 12 injected tumors (25% partial response rate), stable disease with no improvement in 1 treatment site (8.4%). Side effects included local pain, swelling, and erythema, and in one patient flulike symptoms. There were no significant changes of blood tests as compared to baseline levels. Conclusions: The therapeutic response induced by perilesional PEG-IL-2 injections was found to be an encouraging, safe, and well-tolerated treatment of BCC. Further studies including a larger patient population and long-term follow-up are necessary in order to substantiate these findings. [source]

Intravascular papillary endothelial hyperplasia of the lower lip: surgical approach and review of the literature

GERODONTOLOGY, Issue 4 2009
A. Cohen
Objective:, A review of the literature for intravascular papillary endothelial hyperplasia is presented along with a case report of a geriatric patient. Review of the literature:, Intravascular papillary endothelial hyperplasia (IPEH) is a reactive benign lesion of vascular origin, which is caused by an excessive proliferation of endothelial cells. Only a few cases with IPEH in the oral cavity have been recorded in the literature, reporting the lower lip as the main site. The treatment of choice mentioned in the literature is simple excision. Case report:, In this case, an IPEH of the lower lip of a 79-year-old male was treated by a sclerosing agent, which was injected into the lesion, causing compression and fibrosis of the blood vessels, followed by a careful dissection and excision. Intra-operatively no bleeding occurred. Post-operatively an excellent aesthetic result was achieved, without recurrence. Conclusion:, The use of sclerotherapy followed by surgery in mixed type intravascular papillary endothelial hyperplasia can provide an acceptable aesthetic result with minimal intra-operative bleeding. [source]

Surgical Ablation of Atrial Fibrillation: The Columbia Presbyterian Experience

JOURNAL OF CARDIAC SURGERY, Issue 5 2006
Veli K. Topkara M.D.
However, it is not widely applied due to its complexity, increased operative times, and the risk of bleeding. Various energy sources have been introduced to simplify the traditional "cut and sew" approach. Methods: This study involves patients undergoing surgical atrial fibrillation ablation (SAFA) at a single institution from 1999 to 2005. Type of concomitant procedures, preoperative clinical characteristics, and chronicity of AF were evaluated in overall patient population. Parameters including surgical approach, lesion pattern, and energy source used were collected intraoperatively. Clinical outcomes examined were postoperative rhythm success, stroke, early mortality, and long-term survival. Results: Three hundred thirty-nine patients were identified. Three hundred twenty-eight (96.8%) patients had associated cardiac disease and underwent concomitant procedures; 75.8% of patients had persistent AF. Energy sources used were microwave (49.8%), radiofrequency (42.2%), and laser (8.0%). In 41.9% of cases a pulmonary vein encircling lesion was the only lesion created. Combination lesion sets were performed in the remaining cases. Rhythm success rates at 3, 6, 12, and 24 months were 74.1%, 68.2%, 74.5%, and 71.1%, respectively. Patients who underwent surgical removal of left atrial appendage by means of stapling or simple excision had no early postoperative stroke. Early mortality was 4.9%. Postoperative survival rates at 1, 3, and 5 years were 89.6%, 83.1%, and 78.0%. Conclusions: Surgical ablation of atrial fibrillation is a safe and effective procedure in restoring sinus rhythm with excellent postoperative survival rates. Further advancements in the field will eventually result in minimally invasive procedures with higher success rates. [source]